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整脊实践中以人为本的护理方法的采用及其对非特异性脊柱疼痛的影响:一项观察性研究。

The adoption of person-centred care in chiropractic practice and its effect on non-specific spinal pain: An observational study.

机构信息

College of Science, Health, Engineering and Education (SHEE), Murdoch University, 90, South Street, Murdoch, WA, 6150, Australia.

School of Health Sciences, University of Surrey, Faculty of Health and Medical Sciences, Rm 22, DK04, Duke of Kent Building, Guildford, Surrey, GU2 7XH, UK.

出版信息

Complement Ther Med. 2019 Jun;44:56-60. doi: 10.1016/j.ctim.2019.03.023. Epub 2019 Mar 30.

Abstract

OBJECTIVES

The objectives of this study were to identify: 1) the extent to which final year chiropractic students used components of person-centred care in a clinical setting; and 2) determine the effect of chiropractic students' use of person-centred care on musculoskeletal pain.

DESIGN/SETTING: An observational study was conducted at three Western Australian chiropractic teaching clinics.

INTERVENTIONS

Pragmatic individualised chiropractic care was delivered to 108 adults who experienced non-specific spinal pain.

MAIN OUTCOME MEASURES

The instruments used in this study were the Consultation and Relational Empathy questionnaire, Picker Musculoskeletal Disorder Questionnaire, and Numerical Rating scale for Pain intensity.

RESULTS

Participants experienced reductions in pain that exceeded the level required for minimal clinically reported improvement. In addition, high levels of empathy and patient -centred care were reported. Ceiling effects for the measures assessing empathy and patient-centred care precluded analyses examining the relationship between changes in pain intensity, empathy, and patient-centred care.

CONCLUSIONS

The participants in this study displayed very positive attitudes about most aspects of the chiropractic students' person-centred care skills. Person-centred care processes for which there was considerable scope for improvement included advice about alternative treatment options, and the adaptation of lifestyle and workplace situations to alleviate pain and enhance health. Our findings also showed that the participants experienced clinically important improvement in pain. However, the skewed nature of our dataset precluded identifying whether the students' person-centred care skills influenced such improvement.

摘要

目的

本研究旨在确定:1)在临床环境中,最后一年的脊医学生使用以患者为中心的护理的程度;2)确定脊医学生使用以患者为中心的护理对肌肉骨骼疼痛的影响。

设计/设置:在西澳大利亚的三个脊医教学诊所进行了一项观察性研究。

干预措施

为 108 名患有非特异性脊柱疼痛的成年人提供实用的个体化脊骨疗法护理。

主要结果测量

本研究使用的工具是咨询和关系同理心问卷、Picker 肌肉骨骼疾病问卷和疼痛强度数字评分量表。

结果

参与者的疼痛减轻程度超过了最小临床报告改善所需的水平。此外,还报告了高水平的同理心和以患者为中心的护理。评估同理心和以患者为中心的护理的措施存在天花板效应,排除了分析疼痛强度、同理心和以患者为中心的护理变化之间关系的可能性。

结论

本研究的参与者对脊医学生以患者为中心的护理技能的大多数方面表现出非常积极的态度。以患者为中心的护理过程有很大的改进空间,包括提供替代治疗选择的建议,以及调整生活方式和工作场所情况以减轻疼痛和促进健康。我们的研究结果还表明,参与者的疼痛得到了临床上重要的改善。然而,我们数据集的偏态性质排除了确定学生的以患者为中心的护理技能是否影响了这种改善。

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